Experience With Uterine Balloon Therapy For Dysfunctional Uterine Bleeding

Dysfunctional uterine bleeding (DUB) describes all forms of conditions where there is abnormal bleeding for which any organic cause cannot be found. It is classified as ovulatory (polymenorrhoea, polymenorrhagia and menorrhagia) or anovulatory (acyclical heavy bleeding). This bleeding is a common cause of iron-deficiency anaemia contributing to worsening of health (1) with deteriorated quality of life and exaggerated cost of medical expenditure due to increased number of ill health days in a year. When medical treatments fail to provide satisfactory relief from DUB, surgical interventions, including hysterectomy or annihilation of the endometrium, can be considered. (2) To begin with first generation endometrial ablation techniques like rollerball ablation, transcervical resection, and laser ablation were performed under direct hysteroscopic vision to treat abnormal uterine bleeding. These procedures led to significant decrease in the number of hysterectomies performed. (3) Over the past decade, second generation non-hysteroscopic techniques have become the method of choice for treating DUB. Complete destruction of endometrium in the uterine cavity is achieved using high temperature fluids within a balloon (Thermachoice and Cavaterm) (4,5,6) or application of microwave (Microsulis) (7,8) or bipolar radiofrequency electrical energy (Novasure). (9) Uterine balloon therapy (Thermachoice) (Fig I) a second generation endometrial ablation technique is a safe, effective, acceptable, simple to perform, readily available technique with instant results for the management of DUB. This procedure does not require any specialized skill, has less postoperative morbidity with shorter recovery period and can be performed in day care surgery settings under regional or general anaesthesia